Frequently Asked Questions

Tribal Public Health Department Accreditation

1. What is the purpose of the national accreditation program?
2. Why now?
3. How were the tribal accreditation standards, measures and processes developed?
4. How were tribes involved in the development of the national accreditation program?
5. What benefits are anticipated from accreditation? Could accreditation impact funding?
6. What kind of support/technical assistance can tribal public health departments expect from MDH?
7. Why apply for accreditation?
8. When will national accreditation start for health departments?
9. How much will it cost to apply for accreditation?
10. How long does health department accreditation last?
11. How does PHAB differ from other programs in which Indian Health Services participates?


1. What is the purpose of the national accreditation program?

National public health accreditation aims to improve and protect the health of the public by advancing the quality and performance of state, tribal, and local health departments. Accreditation will drive public health departments to continuously improve the quality of the services they deliver to the community (Source: PHAB).

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2. Why now?

Public health departments play a critical, but often unrecognized, role in promoting and preserving the health of people in communities across the country. Despite the important role health departments play in our communities, there has not been a national system for ensuring their accountability and quality – until now.

Other community services and organizations have seen the value of accreditation, such as schools, day care centers, police departments and hospitals. Now, there is an opportunity for public health departments to measure their performance, get recognition for their accomplishments and demonstrate accountability within their communities. Also, as the public health field faces increasing challenges from epidemics and disaster preparedness, it is more important than ever that systems are in place to ensure their effectiveness and quality of services (Source: PHAB).

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3. How were the tribal accreditation standards, measures and processes developed?

PHAB's Board of Directors and the PHAB Standards Development Workgroup, along with significant feedback from public health leaders and practitioners, developed the standards, measures and processes that were formally adopted by PHAB's Board in August 2009 (Source: PHAB).

PHAB worked with the National Indian Health Board (NHIB) to ensure that accreditation standards for tribal health departments addressed the specific needs and challenges of the Tribal public health programs. As the national public health accrediting body, PHAB recognizes the unique and critical role that Tribal governments have in developing the accreditation program (Source: NIHB).

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4. How were tribes involved in the development of the national accreditation program?

In addition to participating in the development of the PHAB Standards and Measures, health departments from three tribal nations participated in a beta test of the accreditation standards and process (the Navajo Nation Division of Health, Window Rock, Arizona; Keweenaw Bay Indian Community, Department of Health & Human Services, Baraga, Michigan; and the Cherokee Nation Health Services, Tahlequah, Oklahoma). PHAB has an ongoing commitment to learn more about tribal public health.

PHAB convened a Tribal Standards Workgroup, on which Deb Smith of the Fond du Lac Band of Lake Superior Chippewa served. This workgroup reviewed accreditation standards and measures while considering unique issues like tribal sovereignty and culturally appropriate approaches to care. This workgroup suggested changes to the final tribal standards.

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5. What benefits are anticipated from accreditation? Could accreditation impact funding?

The external validation and objective feedback from the PHAB accreditation process could have significant potential to accelerate performance improvement.

Health departments will position themselves to capitalize on anticipated funding preferences for accredited health departments. Going through the process will also highlight areas for improvement, and health departments may be able to better frame grant proposals to address those gaps.

The process will provide health departments with an opportunity to think about their mission, vision, and values, and how to do business given the challenging social and economic environment. Accreditation may raise the visibility of public health issues and provide a point of entry for decision-making discussions involving public health.

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6. What kind of support/technical assistance can tribal public health departments expect from MDH?

MDH can provide a variety of training, technical assistance and consulting.

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7. Why apply for accreditation?

The external validation and objective feedback from the PHAB accreditation process could have significant potential to accelerate performance improvements.

The process will provide health departments with an opportunity to think about what business they do and how to do that business given the challenging times.

Accreditation may raise the visibility of public health issues and provide a point of entry for decision-making discussions involving public health. The Forest County Potawatomi Health and Wellness Center identified the following reasons it has decided to apply for accreditation:

    1. We believe in being held accountable to deliver high quality services to our Forest County Potawatomi community members and clients.
    2. We want to be objectively evaluated against similar standards in the public health industry.
    3. We realized that many of our current projects and clinic-wide initiatives are in direct line with Public Health Accreditation (PHA).
    4. Since many of the public health accreditation standards are similar to AAAHC [Accreditation Association for Ambulatory Health Care] standards - much of what is needed for PHA is already being done!
    5. We want to know we are providing quality patient care.
    6. Leadership determined that this was a great opportunity to realize our strengths and recognize our weaknesses in the area of public health.
    7. Attaining PHA will help give recognition to Tribal community health departments, as they will meet the same standards and measures as accredited local public health departments.
    8. We love the fact that the PHA standards are tailored to fit the uniqueness of Tribal health departments and that tribes had into the development of the standards (and ongoing revisions).
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8. When will national accreditation start for health departments?

PHAB released the final Standards and Measures [Attn: Non-MDH link] in July 2011. Applications for accreditation will open in October of 2011.

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9. How much will it cost to apply for accreditation?

You can find more information the cost of accreditation at
PHAB: Fee Overview [Attn: Non-MDH link].

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10. How long does health department accreditation last?

A five-year accreditation cycle has been adopted by the PHAB Board.

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11. How does PHAB differ from other programs in which Indian Health Services participates?

Other types of accreditation aim to promote quality of services and performance, based on a national set of standards, but differ in the types of entities eligible to apply and the types of services to be improved by standards. Each accrediting body is a unique entity that has different policies, procedures, standards, methodology for revising its standards, length of awarding accreditation, etc.

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